When you go blind, you miss seeing little things you once took for granted, but even more painful, said Diane Bellavance, are the little wonders you miss seeing at all.

“There were eight babies born in my family this year,” she said, choking back emotion in her New Auburn home. “I’ve never seen their faces. I’ll never know what they look like.”

Bellavance, 58, has struggled with diabetes from age 24, when diagnosed while pregnant with her first child. Today, she takes 32 pills each day and must inject herself with three types of insulin. Sadly, all those medications have proven unequal to the ravages of this insidious disease. Bellavance has suffered a host of complications, from memory loss, to kidney troubles, to a stroke. She has lost all feeling in her legs and fingertips. About six years ago, her vision began to fade. Today, she is totally blind in her left eye, the vision in her right reduced to ghostly shadows.

“It’s been hard, ” she said, “especially knowing that, even though I took my medications, I ate what I wanted. I should have followed my diet from the beginning, but I was fighting against myself. I was like a yo-yo with my weight, up and down, up and down. I had a deep depression at one point 13 years ago. I had a hard time accepting it.”

Geana Ferrell, a registered nurse in the Central Maine Medical Center emergency room, explained the difference between the two versions of diabetes — Type I, also know as juvenile-onset diabetes, and Type II, which is becoming endemic, affecting nearly 8 percent of the U.S. population, according to the American Diabetes Association.

“You have glucose and insulin cells and there are ‘keys’ that help unlock them, to let them connect,” she said. “In a normal person, our cells communicate very well.”

When a person consumes carbohydrates (starches and sugars), the body breaks them down into simpler forms, such as monosaccharide glucose, our principle energy source from food. This triggers the pancreas to create beta cells, which fill the blood stream with insulin, a hormone used by two-thirds of the body’s cells to absorb glucose and power their internal engines.

“In the Type II diabetic,” said Ferrell, “the body makes plenty of insulin, but there are ‘blockers’ like fat and cholesterol that won’t let the cells communicate. That’s why, when you exercise and do your diet, you can minimize your need for insulin and oral medications, because the cells become less confused.

“With Type I, it’s almost like a cancer,” said Ferrell. “It’s an auto-immune disorder. It has nothing to do with diet and exercise. It has everything to do with the fact that the body recognizes it as a foreign substance, so the cells start to destroy themselves until the pancreas stops making insulin altogether.”

Ferrell understands the difference in diabetes types better than most. Her twin, teenage sons have battled the Type I form from age four, when one first exhibited some of the classic warning signs — frequent urination (known as “polyuria”), increased thirst (polydipsia), and constant hunger (polyphagia).

“What happens is that, because the glucose is not getting absorbed, your body almost tricks itself into thinking it’s starving,” said Ferrell, who knew something was up when her son began to guzzle tumbler after tumbler of water. “You literally go into starvation mode.”

Whether insulin is absent or incommunicado, the failure to metabolize glucose is chronic, leading to a host of maladies, as fine nerve endings get clogged with unused sugars.

The ADA says diabetes was the 7th leading cause of death in the U.S. in 2006, by which time it was the leading cause of kidney disease and blindness in adults aged 20 to 74. Diabetics also have risk factors for heart disease and stroke four times that of healthy adults, while accounting for 60 percent of all non-traumatic lower-limb amputations. In 2007, the ADA pegged the annual medical cost of all forms of diabetes in the U.S. at $218 billion.

Close to home, the Maine Center for Disease Control estimates that 77,219 Mainers (7.5 percent) had diabetes in 2005, double the number from a decade earlier and contributing to 9.5 percent of all state deaths that year. MaineCare has calculated that 15 percent of its FY2003 payouts (almost $243 million) were channeled toward diabetics.

Bellavance said at one point her husband, Jerry, worked three jobs to cover the annual $25,000 cost of her medications. Ferrell said she spends $400 per month in co-payments on diabetic supplies for her sons, having recently been forced to forego the insulin pumps they once used as too costly, at “$2,400 every few months.”

Still, the cost of diabetes can be nothing compared to the required changes in lifestyle.

“It’s a hard adjustment,” said Ferrell. Her sons, she added, had difficulty understanding why they had to continue the regimen even when they began to feel better. “This isn’t like cough medicine,” she told them, “you have to do this every day for the rest of your life.

“This is forever,” said Ferrell, “You never get a break. That’s huge.”

Bellavance agreed. She’s lost 40 pounds in the last year, and spends hours each day calculating her calorie and carbohydrate intake with Jerry, using Excel formulas he created.

“I’m 58 and, look, I’m doing it now,” she said, “but it’s a little late. I’m blind and I have all these other problems. You have to control it right from the beginning. You have to control your weight and your diet.

“Don’t wait,” said Bellavance. “Go to your doctor, go to your dietician, see a counselor. Write down your questions and be sure to ask them all, but don’t wait. That’s key, don’t wait.”